Open Access Short Communication

Proof-of-Concept of Acute Drug-Elicited Defecatory Behaviors in Spinal Cord-Transected Animals: A Model for Identifying Centrally-Acting Prokinetic Agents

Inge Steuer, Magali Grob, Pierre A. Guertin

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/19033

No cure and no safe or acceptable treatment exist yet against bowel problems and chronic constipation in spinal cord-injured (SCI) patients. Although some non-central nervous system (CNS)-acting drugs have already been identified and used clinically as symptomatic treatment, most have been associated with significant side effects and deleterious complications. To ease basic research aimed at identifying new drug candidates against bowel control problems, we developed a standardized approach and corresponding assays for quantitatively measuring prokinetic and acute defecatory effects in paraplegic animals. Following a period of acclimation, a single subcutaneous injection of 0.5 ml of vehicle (sterile water) was performed in normal animals or in early chronic (> 7 days post-surgery) low-thoracically (Th9/10)-transected (Tx) mice. A 30 minute-period of observation of freely moving animals using a transparent Plexiglas arena was used to subsequently measure timing (latency of each episode), amounts (fecal pellets in mg) and frequency (number of episodes/30 min). Residual activity levels, clearly determined in control animals, were used as baseline level to determine statistically greater effects induced by compounds of potential interest. Tests with SR57227 (5-HT3 receptor agonist) and quipazine (5-HT2/3 receptor agonist) revealed that only quipazine acutely elicited significantly greater amounts of fecal pellets in Tx mice. Using this straightforward and reliable method, future drug screening experiments that may yield the identification and development of new potent and safe centrally acting-drug treatments (e.g., upon the Lumbosacral Defecation Center) for potent ‘on-demand’ facilitation or induction of reflex bowel control and acute episodes of defecation in patients with SCI.

Open Access Original Research Article

Effects of Exercise on the Amelioration of Fatigue in Cancer Survivors: A Pilot Study

Danielle F. Namour, Annette F. Custereri, Stephen J. Sylvester, David M. Compton, Angie McDonald

Journal of Advances in Medicine and Medical Research, Page 1-10
DOI: 10.9734/BJMMR/2016/20214

Aims: To acquire preliminary information in order to assess the efficacy of a university-based exercise program developed to serve members of the community suffering from symptoms associated with cancer fatigue.

Study Design: The pilot study included 35 adult cancer patients who underwent intensive medical screenings to ensure that the exercise program would be appropriate for them. Each participant was assigned an individual student to guide him or her through specific exercises for 8 successive weeks, meeting 3 times per week. At the end of each week, the participants filled out the Fatigue Symptom Inventory, designed to assess cancer-related fatigue on three dimensions – intensity, duration, and interference with daily life.

Place and Duration of Study: Department of Health and Human Performance, Health and Wellness Center, Palm Beach Atlantic University, West Palm Beach, FL, USA. Between September, 2012-December, 2014.

Methodology: Each participant had one student (exercise science or pre-occupational therapy) assigned to work with them and guide them through specific exercises. All exercise routines were specially designed by a registered physical therapist who had conducted all evaluations, had previously designed, and implemented the Exercise Fatigue Program. During the workout, a second measurement of blood pressure and pulse rate was recorded. After the workout was complete, the participants participated in a series of stretching activities. Stretching exercises were followed by a third and final measurement of resting blood pressure and pulse rate.

Results: Evidence was found that, among those who remained in the exercise program experienced less intense and shorter duration fatigue levels and reported lower levels of interference in activities of daily living (ADLs) associated with cancer-related fatigue patients.

Conclusion: Supervised exercise regimens adapted to the needs of individual cancer patients show promise in reducing the symptoms associated with cancer-related fatigue. However, because of the limited sample size and participant attrition, the results reported here should be considered preliminary in nature. Further work using a larger sample size with more systematic consideration of possible confounding variables is required in order to validate the program.

Open Access Original Research Article

Correlation between Glycated Hemoglobin and Serum Lipids in Type 2 Diabetics in Eastern Libya

Nura Mohammed Naseb, Ramesh Naidu Yedla, Khalid Saleh Gharib, Jagannadha Rao Peela, S. Shakila, Abdul Rehaman Said, Laxmi Teja Peela, Sobha Devi Kolla, Sainath Jagannath Doiphode, Anuradha Argi, V. Laxmi Kalpana, Avinash Rawal, Soe Naung

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/18537

Introduction: Type 2 diabetes is an increasingly common metabolic disorder characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diabetes mellitus is frequently associated with dyslipidemia and an increased percentage of glycated hemoglobin. Patients with type 2 diabetes mellitus are at increased risk for cardiovascular complications.

Objective: To assess the relationship between glycemic control (as reflected by glycated hemoglobin; HbA1c) and serum lipid profile in type 2 diabetic patients.

Materials and Methods: A total of 60 patients were selected from those attending Diabetes Mellitus Clinic, Seventeenth of February Teaching Hospital, Al- Baida as outpatients. The subjects were divided into 3 groups such as group I as the control group, group II as the diabetic group with all related complications excluded and group III as those with type 2 DM with atleast cardiovascular event in the last two years considered as cardiovascular complication of DM. Blood samples were collected from all the subjects and tested for glucose level, glycated hemoglobin, total cholesterol, triglycerides and HDL cholesterol using authenticated reagents kits on an auto analyzer. LDL cholesterol was calculated using Friedwald’s formula.

Results: The levels of glycated hemoglobin (p<0.0001), fasting glucose level (p<0.0001) and triglycerides (p<0.0001), were significantly raised and HDL cholesterol (p<0.0001) is found to have significantly decreased in diabetic patients with or without cardiovascular complications.  In those patients with diabetic complications, total cholesterol and low density lipoprotein cholesterol were significantly raised and high density lipoprotein cholesterol significantly decreased when compared to control subjects.

Conclusion: The findings of the study showed significant positive correlation between glycated hemoglobin with the levels of total cholesterol, triacylglycerol, and low density lipoprotein cholesterol in both control and diabetic groups with or without complications. Glycated hemoglobin level was significant and positively correlated with total cholesterol and triglycerides in type 2 DM.

Open Access Original Research Article

Ultrasound Examination of Cardiovascular Profiles of Runners Participating in High Altitude Race and their Possible Influence on Performance: A Randomized Cross-sectional Study

Orelien Sylvain Mtopi Bopda, Martin Anchang Salah, Vincent Siysi Verla, Calvin Tonga, Jacques Cabral Tchoumi Tantchou

Journal of Advances in Medicine and Medical Research, Page 1-11
DOI: 10.9734/BJMMR/2016/19844

Objectives: This work was aimed at investigating, by means of ultrasonography, the impact of cardiovascular parameters on the physical endurance of runners participating in high altitude race.

Experimental Design: This was a cross-sectional study.

Place and Duration of the Study: The study was carried out in Cameroon. Anthropometric and cardiovascular parameters were recorded at the Regional Hospital annex of Buea (Cameroon) on the 12th and 13th February while race times were recorded at Molyko Stadium of Buea, on the 15th February 2014.

Methodology: Out of 241 runners who finished the senior Mount Cameroon Race of Hope, 69 who were at least at their second participation, had voluntarily participated in the study. Haemodynamic parameters were collected through 2D transthoracic ultrasonography. Mann-Withney or Kruskal-Wallis tests and linear regression were used for statistical analysis. The significance level was set at p-value<0.05.

Results: The mean LVEDD, LVDV, LVSV, LVMMI, SF/EF and TAPSE were 2.7±0.3 cm/m2, 88.5±49.3 mL/m2, 53.4±30.7 mL/m2, 131.1±28.6 g/m2, 69.3±9.4% and 1.7±0.3 cm/m2 respectively. In males and females, LVDV (mL/m2) was 98.6±55.3 vs. 64.2±12.6 (p=0.011) while LVSV (mL/m2) was 61.6±33.2 vs. 33.9±6.2 (p=0.0004), respectively. The linear regression model revealed that the lower the altitude, the greater the race time i.e. the weaker the performance (p=0.005; r2=0.12). In addition increase of LVDV related with increase of residential (p=0.025; r2=0.12) and training (p=0.021; r2=0.13) altitudes.

Conclusion: Optimal values of haemodynamic parameters and/or high training altitude could be boosters of performance in endurance race at high altitude.

Open Access Original Research Article

Behavior Correlates of Post-Stroke Disability Using Data Mining and Infographics

Sunmoo Yoon, Jose Gutierrez

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/BJMMR/2016/21601

Purpose: Disability is a potential risk for stroke survivors. This study aims to identify disability risk factors associated with stroke and their relative importance and relationships from a national behavioral risk factor dataset.

Methods: Data of post-stroke individuals in the U.S (n=19,603) including 397 variables were extracted from a publically available national dataset and analyzed. Data mining algorithms including C4.5 and linear regression with M5s methods were applied to build association models for post-stroke disability using Weka software. The relative importance and relationship of 70 variables associated with disability were presented in infographics for clinicians to understand easily.

Results: Fifty-five percent of post-stroke patients experience disability. Exercise, employment and satisfaction of life were relatively important factors associated with disability among stroke patients. Modifiable behavior factors strongly associated with disability include exercise (OR: 0.46, P<0.01) and good rest (OR 0.37, P<0.01).

Conclusions: Data mining is promising to discover factors associated with post-stroke disability from a large population dataset. The findings can be potentially valuable for establishing the priorities for clinicians and researchers and for stroke patient education. The methods may generalize to other health conditions.

Open Access Original Research Article

Paediatric Renal Dialysis at the End of the 20th Century in Ibadan Nigeria

A. O. Asinobi, O. O. Ogunkunle

Journal of Advances in Medicine and Medical Research, Page 1-9
DOI: 10.9734/BJMMR/2016/20470

Aim: To document the conditions requiring dialysis in children at the University College Hospital, Ibadan Nigeria, at the end of the 20th century, as well as the available dialytic modalities and short-term outcomes of dialysis for future comparisons.

Patients and Methods: The data of all children aged 15 years and below who underwent peritoneal dialysis or haemodialysis in the Dialysis Unit between January 1990 and December 1999 were reviewed. A descriptive analysis of patients’ demography, aetiology of kidney failure, dialytic modalities and short-term outcome in these patients was performed. The primary outcome measure was mortality.

Results: Sixty-six children comprising 14 (21%) boys and 52 (79%) girls underwent dialysis. The mean age was 11.9 (SD 3.9) years. Fifty-eight (88%) underwent peritoneal dialysis and 8 (12%) haemodialysis. A definitive diagnosis of Stage 5 chronic kidney Disease was made in 25 (38%), acute kidney injury in 23(35%) and acute kidney injury-on-chronic kidney disease in 6 (8%).The major underlying conditions were the nephrotic syndrome, acute glomerulonephritis and chronic glomerulonephritis. Others were diethylene glycol poisoning, malignancies and sepsis. Only acute dialysis was offered because of limited resources.

Overall 25 died, giving a mortality rate of 37.9% with 12 (48%) and 22 (88%) patients dying within 3 days and 2 weeks of presentation respectively. Thirteen of the 25 (52%) patients in Stage 5 CKD, and 9 (39.1%) of the 23 with AKI, died and the mortalities were related more to the aetiologies.

Conclusion: Acute glomerulonephritis and Nephrotic syndrome were the major causes of AKI while chronic glomerulonephritis was the major identified cause of Stage 5 CKD. The available dialytic modalities were peritoneal dialysis and the then newly introduced haemodialysis. Patients had no insurance cover and paid out of pocket for treatment thereby limiting the duration of dialysis. The short-term outcome compared favourably with outcomes in centres with similar predicaments.

Open Access Original Research Article

A Study of Prevalence of Metabolic Syndrome in Patients of Psoriasis of North India

Ashish Dalal, Aneet Mahendra, Sanjeev Gupta

Journal of Advances in Medicine and Medical Research, Page 1-8
DOI: 10.9734/BJMMR/2016/20759

Aim: To assess the prevalence of Metabolic Syndrome in patients of psoriasis and its relation with disease severity.

Materials and Methods: The study was cross sectional and hospital based. It was conducted on one hundred psoriasis patients of psoriasis between 18 to 70 years of age and of either sex. The severity of disease was assessed using PASI and BSA involved. Metabolic syndrome was diagnosed on the basis of South Asian Modified National Cholesterol Education Program’s Adult Treatment Panel III.

Results: The overall prevalence of MS in our study was 42%, which is nearly three times as compared with the prevalence of MS in general population. Presence of MS did not have any association with the severity of psoriasis as assessed by PASI and BSA involvement. Overall disturbances in lipid profile (31% and 29% were having high TG level and low HDL level respectively) and abdominal obesity (30%) were the most important factors contributing to increased prevalence of MS. These were followed by increased BP(26%) and high FPG level (23%).

Conclusion: Due to increased prevalence of MS in psoriasis, dermatologists should go for simple cardiovascular evaluations like BMI, blood pressure, fasting plasma glucose and lipid profile to prevent further morbidity.

Open Access Original Research Article

Epidemiology of Head and Neck Cancers in Maiduguri-Northeastern Nigeria

Aliyu M. Kodiya, Adamu I. Adamu, Haruna A. Nggada, Hamman I. Garandawa, Yusuf B. Ngamdu, Mala B. Sandabe, Abdullahi Isa

Journal of Advances in Medicine and Medical Research, Page 1-7
DOI: 10.9734/BJMMR/2016/20344

Head and neck cancers is one of the common health problems in our environment affecting relatively the youth. The paucity of literature on community based studies in Nigeria to determine the incidence of the disease obscure its burden, pattern and magnitude. This study presents epidemiological characteristics of head and neck cancers in Maiduguri as seen during the period of insurgency. 

A 5 year retrospective review of patients seen from January, 2010 to December, 2014 with histologically diagnosed head and neck cancers. Data extracted from the records of histopathology department of University of Maiduguri Teaching Hospital was analyzed using SPSS version 16.0.

Of the 7655 patients, 1312 (17.14%) were cancers and 217 (16.54%) of this was head and neck malignancies. Average age was 35.5years with SD±20.07. About 69% of cases were epithelial in origin and 60.83% of patients were less than 41 years of age. The age group worse affected by carcinoma is older than those with sarcoma and lymphoma.

Head and neck is not uncommon in Maiduguri even in the face of insurgency, it is also among one of the common health problems of the relatively young. This therefore call for in-depth research on aetiological factors. Relevant authorities shall also establish oncology centers which will promote education, screening programmes, early detection, prevention and control of head and neck cancers.

Open Access Original Research Article

In vivo Studies on the Phytotherapeutic and Fertility Effects of Dracaena Arborea Extract in Alloxan-induced Type 1 Diabetic Male Rats

Oluwaseyi Samson Ogunmodede, Saheed Oluwasina Oseni, Josephine Oluwagbemisola Oyekan, Sodiq Kolawole Lawal, Omoniyi Abdulazeez Adeoye

Journal of Advances in Medicine and Medical Research, Page 1-18
DOI: 10.9734/BJMMR/2016/21640

Aim: This study was designed to explore and exploit the phytotherapeutic and fertility effects of ethanolic leaf extract of Dracaena arborea in type-1 Alloxan-induced diabetic rats. The phytotherapeutic effects of Dracaena arborea on hematological parameters, appetite, spermiogram, histological architecture and histomorphometrics (stereology) of testicular and/or pancreatic tissues of treated and untreated rats were carried out.

Place and Duration of Study: Department of Anatomy, College of Medicine, Lagos State University, Ikeja, Lagos, Nigeria, between October, 2012 and February, 2013.

Methodology: 24 healthy normal male rats were recruited for this study. They were divided into four groups in a randomized trial; with group A consisting of non-diabetic healthy rats that received only the vehicle (0.5 mg/kg of 2% acacia solution); while group B, C & D was injected intraperitoneally with a single dose of Alloxan monohydrate (ALX) at 100 mg/kg prior to DAE treatment. Groups C and D were subsequently administered DAE orally 72 hours post administration of ALX, at daily doses of 100 mg/kg and 300 mg/kg respectively.

Results: ALX (100 mg/kg) was found to induce type 1 diabetic conditions in the rats, demonstrated by the significant increase (P < 0.05) in the glucose levels, and a decline in appetite (water and food intakes). Conversely, administration of DAE at 100 and 300 mg/kg revealed significant dose and time- dependent increase (P < 0.05) in glucose tolerance and appetite (water and food intakes) in DAE treated groups compared to the untreated or ALX treated only group. Significant normalization (P < 0.05) of red blood cell count, packed cell volume and Hemoglobin levels were also observed in diabetic rats treated with the 100 mg/kg and 300 mg/kg DAE. In addition, testicular and pancreatic histopathological profiles of both DAE treated groups show evidences of appreciable normalization of ALX-induced pathology.

Conclusion: Our findings indicates that DAE may offer great therapeutic benefit in the treatment of type-1 diabetes mellitus and normalizing testicular dysfunction or infertility in diabetic patients.

Open Access Review Article

Hydroxyethyl Starch- Friend or Foe?

Katarina Tomulic Brusich, Ivana Acan, Natasa Viskovic Filipcic

Journal of Advances in Medicine and Medical Research, Page 1-12
DOI: 10.9734/BJMMR/2016/20278

Resuscitation with intravenous fluid therapy is considered a corner stone in the management of critically ill patients in most acute conditions. In daily practice, the assessment of individual thresholds in order to optimize cardiac preload and avoid hypovolemia or deleterious fluid overload remains a challenge.

The choice of fluids for intravascular volume replacement has been debated for decades. More recently, this debate has focused not only on colloids versus crystalloids, but more specifically on the choice of colloid solutions.

Hydroxyethyl starch (HES) solutions, developed as less-expensive alternatives to albumin, are commonly employed for volume resuscitation in the perioperative period as well as in ICU patients. However, lately, the resuscitation with HES has become controversial due to its adverse effect regarding impaired coagulation, renal insufficiency and mortality.

Therefore, a narrative review of recent literature was undertaken to establish the current utility and efficacy of HES in clinical practice. Prospective randomized controlled trials published between January 2008 and March 2015 with measures of outcome/mortality and adverse effects of HES administration were included. This review aims at increasing awareness amongst anesthetists and critical care specialist about correct and careful fluid administration.